New Test May Spot Which Embryos Stand Greatest Chance of Survival

MONDAY, Oct. 14 (HealthDay News) -- Doctors have unveiled a new
test for determining which embryos have the best chance of
survival.

The amount of mitochondria found in the cells of an embryo
appeared to be a marker of its health, doctors reported Monday at
the International Federation of Fertility Societies and American
Society for Reproductive Medicine annual meeting in Boston.
Research presented at meetings is considered preliminary until
published in a peer-reviewed medical journal.

Higher levels of mitochondria -- the "powerhouses" of cells --
seemed to indicate an embryo was under stress and less likely to
successfully implant in a woman's uterus, said study co-author Dr.
Dagan Wells, a scientific leadership fellow at Oxford University in
England.

The researchers were able to establish a mitochondrial threshold
above which they felt sure an embryo wouldn't be able to implant in
a uterus, he said.

By selecting the healthiest embryos, doctors hope to cut down on
unsuccessful implantations and miscarriages.

Doctors already can screen embryonic cells to make sure they
have the proper number of chromosomes. Previous research has found
that if embryos have more or fewer than the usual 46 chromosomes --
23 from the mother and 23 from the father -- they rarely survive
implantation, Wells said.

When doctors add the mitochondria test to the chromosome count,
they will be able to increase the rate of successful embryo
implantation from between 60 percent and 65 percent to as high as
80 percent, he said.

"We think this will get us to a significantly improved birth rate, and we are planning clinical trials," Wells said.

Dr. Joe Leigh Simpson, president of the International Federation
of Fertility Societies, hailed the new findings as creating a
"better mouse trap" for screening embryos.

"We can simply add mitochondrial assessment at the same time as chromosomal screening, and better address the disappointment of why we don't get a success," Simpson said. "I would look upon this as providing transformative information. There would be fewer cycles required to produce a baby that one could take home."

In the 30 years since the discovery of in vitro fertilization,
more than 5 million babies have been born worldwide due to the
technique. "In any classroom, there's likely to be one or two IVF
children among them," Wells said.

But the process is still relatively inefficient. "Only about 30
percent of IVF cycles actually produce a baby," Wells said. "Many
patients have to undergo multiple IVF cycles before they finally
achieve that much-desired baby."

Researchers decided to look at mitochondria as a possible
culprit for unsuccessful implantation. Mitochondria are responsible
for creating usable forms of energy for a cell. They also are
involved in key cellular processes such as cell signaling, cell
differentiation and programmed cell death.

The doctors reviewed the amount of mitochondrial DNA present in
219 embryos produced by 59 couples.

They found that mitochondrial DNA was elevated in the embryos
produced by women in their late 30s and 40s, and also was elevated
in embryos with the wrong number of chromosomes. The embryos that
had the worst chromosomal abnormalities had the highest levels of
mitochondrial DNA.

Researchers then implanted embryos that appeared healthy,
regardless of their mitochondria levels. "These are embryos we
would have high hopes for," Wells said. "They look good under the
microscope. They did not have chromosome abnormalities."

However, only half of the implantations produced a baby.

Based on those findings, doctors established a threshold amount
of mitochondrial DNA. "Embryos above that level never implant,"
Wells said. "About 25 percent of embryos that are chromosomally
normal but fail to implant have these elevated levels of
mitochondrial DNA."

They verified their findings by repeating the test on a second
set of embryos using next-generation genetic sequencing. "It
appears this is a genuine phenomenon," Wells said.

Chromosome screening is an expensive procedure, costing about
$3,000, but Wells said a mitochondria screen could be added to the
same procedure without increasing the cost.

"The mitochondrial screen could potentially be a free add-on on top of chromosomal screening," he said, given that both require a physician to take a few cells from the embryo and pass them on to a genetics lab. "Once you've got those cells, you might as well do as much as you can with them."

Wells warned, however, that the screen only sorts the potential
viability of embryos. "These kind of tests aren't a magic bullet.
They aren't going to make the embryos any more viable," he said.
"In some IVF cycles, you're not going to get any viable
embryos."

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.